nteractions with other medicines

When two or more medicines are taken at the same time, the effects of one of the medicines can be altered by the other (drug-drug interaction). Aspirin can interact with other medicines.

Some of the more common interactions are listed below. However, this is not a complete list.

If you want to check your medicines are safe to take with aspirin, ask your doctor or pharmacist, or read the patient information leaflet that comes with your medicine.

Anti-inflammatory painkillers

Aspirin should not be taken with anti-inflammatory painkillers such as diclofenac, ibuprofen, indometacin or naproxen, as this increases the risk of bleeding in the stomach.

Read more information on these medicines on our anti-inflammatory painkillers medicines info page.

Methotrexate

Aspirin can reduce the body’s ability to remove methotrexate, and can therefore increase your risk of serious side effects from this drug.

SSRI antidepressants

Taking aspirin with SSRI antidepressants such as citalopram, fluoxetine, paroxetine, sertraline or venlafaxine may increase your risk of bleeding.

Read more information on these medicines on our SSRI antidepressants medicines info page.

Warfarin

Warfarin is an anticoagulant medicine that prevents your blood from clotting. Aspirin taken with warfarin can increase your risk of bleeding. However, there are some situations where you may be advised by your doctor to take aspirin and warfarin together.

Interactions with food and alcohol

There are no known interactions between aspirin and food.

However, it is a good idea to take aspirin with or after food, to help reduce irritation to the stomach.

It may be safe to drink alcohol with some painkillers that can be bought over the counter (OTC), as long as you:

• check the patient information leaflet that comes with the medicine


• take the correct dose of your medicine


• do not drink more than the maximum recommended daily limits of alcohol

Taking more than the recommended dose of aspirin or ibuprofen increases the risk of irritation to your stomach lining. This risk is increased further if you drink more than the recommended daily limits and may lead to bleeding from the stomach.

nteractions with other medicines

Categories: anti-inflammatory, daily limits, inflammatory painkillers, information leaflet, medicines info, patient information, recommended daily, ssri antidepressants

Interactions with other medicines

When two or more medicines are taken at the same time, the effects of one of the medicines can alter the effects of the other. This is known as a drug-drug interaction. Clopidogrel can interact with other medicines.

Some of the more common interactions are listed below. However, this is not a complete list.

Increased risk of bleeding

There is an increased risk of bleeding when clopidogrel is taken with some other medications including:

• non-steroidal anti-inflammatory painkillers (NSAIDs) – such as diclofenac, ibuprofen and naproxen


• dipyridamole – another type of antiplatelet


• warfarin – an anticoagulant medicine that prevents your blood from clotting

If you want to check your medicines are safe to take with clopidogrel, ask your doctor or pharmacist or read the patient information leaflet that comes with your medicine.

Interactions with food and alcohol

There are no known interactions between clopidogrel and food, although it is a good idea to take clopidogrel with or after food, to help reduce irritation to the stomach.

It may be safe to drink alcohol with clopidogrel as long as you:

• check the patient information leaflet that comes with the medicine


• take the correct dose of your medicine


• do not drink more than the maximum recommended daily limits of alcohol

Taking more than the recommended dose increases the risk of irritation to your stomach lining. This risk is increased further if you drink more than the recommended daily limits and may lead to bleeding from the stomach.

Interactions with other medicines

Categories: clopidogrel, daily limits, increased risk, information leaflet, interactions, medicines, patient information, recommended daily

Overview of Antiplatelets, clopidogrel

Clopidogrel (brand name Plavix) is an antiplatelet medicine. This means it reduces the risk of blood clots forming.

This cuts your risk of having a stroke or heart attack. Normally, when there is a cut or break in a small blood vessel, a blood clot forms to plug the hole until the blood vessel heals.

Small cells in the blood called platelets cause the blood to clot. When a platelet detects a damaged area of a blood vessel, it produces a chemical that attracts other platelets and makes them stick together to form a blood clot.

Clopidogrel reduces the ability of the platelets to stick together and reduces the risk of clots forming.

When is clopidogrel used?

You may be given clopidogrel if you have had:

• a heart attack


• a stroke or transient ischaemic attack (TIA)


• acute coronary syndrome (minor heart attack or unstable angina)


• a coronary stent (a device to open up a blocked artery to the heart)

Clopidogrel and low-dose aspirin

Sometimes, you may be given both low-dose aspirin and clopidogrel. Taken together, they are very effective, but there is a higher risk of bleeding, usually in the gut. This risk increases with age. The key question for your doctor is whether the benefits outweigh the extra risk.

This combination treatment should usually be taken for no longer than nine to 12 months. After this period, just take low-dose aspirin.

Things to consider

If you have certain health conditions such as a peptic ulcer or bleeding disorder you should not take clopidogrel.

Clopidogrel must not be given to anyone under 16 years old, unless under specialist advice. It is also not recommended if you are pregnant or breastfeeding.

You should use clopidogrel with caution if you have liver or kidney problems or are at risk of bleeding.

Read more about things to consider before taking clopidogrel.

Side effects

Although serious reactions are rare, clopidogrel can cause side effects including indigestion and nausea.

Read more about the side effects of clopidogrel.

Clopidogrel can also interact with other medicines. Always read the patient information leaflet that comes with your medicine to check it is safe to take with clopidogrel. If you are unsure, ask your pharmacist or GP.

Read more about how clopidogrel interacts with other medication.

Missed or extra doses

If you forget to take your dose of clopidogrel, take that dose as soon as you remember, then continue to take your course of clopidogrel as normal.

However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you have to take two doses closer together than normal, there is an increased risk of side effects.

The patient information leaflet that comes with your medicine should also give you advice about what to do.

If you accidentally take an extra dose or doses of clopidogrel, contact your GP or call NHS Direct on 0845 4647 for advice.

Overview of Antiplatelets, clopidogrel

Categories: blood clot, blood vessel, clopidogrel clopidogrel, clots forming, dose aspirin, Heart Attack, information leaflet, patient information

Overview of Anti-inflammatories, non-steroidal

Non-steroidal anti-inflammatory drugs (NSAIDs) are a medication widely used to:

• relieve pain


• reduce inflammation (redness and swelling)


• bring down a high temperature (fever)

NSAIDs are used to treat a wide range of conditions.

Common acute (short-term) conditions that can be treated with NSAIDs include:

• headaches


• painful periods


• toothache


• soft tissue injuries such as sprains and strains


• infections, such as the common cold or the flu (NSAIDs do not treat the underlying infections, but can help to relieve symptoms; especially fever)

Common chronic (long-term) conditions that can be treated with NSAIDs include:

• most types of arthritis, including rheumatoid arthritis and osteoarthritis


• back pain


• neck pain

Things to consider when using NSAIDs

NSAIDs are associated with a small increase in the risk of a person experiencing a heart attack, stroke or heart failure.

NSAIDs are only used in people who have an existing high risk of developing these types of conditions if there are no suitable alternatives and the medications bring significant benefit.

High-risk groups include:

• those with a history of previous heart attack, stroke or heart failure


• people aged 75 or over


• people with diabetes


• smokers


• people with high blood pressure

NSAIDs are also not usually recommended for people who:

• are pregnant or breastfeeding


• have a history of kidney disease


• have a history of liver disease


• have active stomach ulcers (a sore in the lining of the stomach), or are at risk of developing stomach ulcers

Read more about the things to consider when using NSAIDs.

For people who are unable to take NSAIDs for medical reasons, the painkiller paracetamol can be used as a safe alternative. For more severe pain, prescription painkillers, such as codeine or tramadol, can be tried.

Or in cases of severe inflammation an injection of steroids (corticosteroids) can often help.

Read more about alternatives to non-steroidal anti-inflammatory drugs.

Side effects

Most people take NSAIDs without having any side effects. Short term use is unlikely to cause significant problems, especially in younger patients.

If side effects do occur they usually affect the stomach and intestines (gastrointestinal tract) and can include:

• indigestion


• stomach ulcer


• allergic reactions

In older patients (aged over 55), or those who have had previous stomach ulcers, but who need long term NSAID treatment, stomach acid suppression medications are often prescribed in combination with NSAIDs to reduce the risk of stomach ulcer complications.

Read more about the side effects of NSAIDs.

Interactions

It is very important to read the patient information leaflet that comes with your medication as some NSAIDs can either react unpredictably with other medications, or make them less effective.

For example, it is usually not recommended to take an NSAID if you are also taking medication to prevent blood clots such as low-dose aspirin or warfarin.

Read more about potential interactions that can occur with NSAIDs.

Dosage

NSAIDs are available in:

• tablet or capsule form


• as a topical treatment (a cream, gel or lotion rubbed into a specific part of the body)


• eye drops – used to treat eye pain

Less commonly, NSAIDs are used as a suppository – a capsule inserted into the rectum (back passage).

It is important to strictly follow all of the instructions about the recommended dosage for your particular NSAID. If you exceed the recommended dose, you risk experiencing a wide range of adverse effects, some of which can be serious.

Read more about the recommendations on dosage for NSAIDs.

Names

In Europe, the most commonly prescribed NSAIDs are:

• diclofenac


• ibuprofen


• naproxen


• celecoxib


• mefenamic acid


• etoricoxib


• indometacin


• aspirin (in doses greater than 600mg)

Most of the NSAIDs listed above are generic medicines. This means that their production and distribution is not limited to a single company. Therefore, they are available under a range of different brand names.

Some NSAIDs are available over-the-counter, without the need for a prescription, such as aspirin, diclofenac, naproxen and ibuprofen.

However, because a medication is available over the counter it does not mean it is safe or suitable for everyone. Again, it is important to read the patient information leaflet that comes with your medication.

It is generally accepted that naproxen is the safest NSAID with regard to heart attacks and strokes and celecoxib is the safest with regard to stomach problems.

Note: Aspirin must NOT be given to children unless directed by a doctor. Also, some people with asthma get attacks triggered by aspirin or NSAIDs.

Anti-inflammatory:Anti-inflammatory medicines reduce swelling and inflammation.
Fever:A fever is when you have a high body temperature (over 38C or 100.4F).
Inflammation:Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Joints:Joints are the connection point between two bones that allow movement.
Migraines:A migraine is type of recurring headache. It is usually accompanied by nausea, vomiting and sensitivity to light and sound.

Overview of Anti-inflammatories, non-steroidal

Categories: anti-inflammatory, attack stroke, Heart Attack, high risk, information leaflet, short term, stomach ulcers, term conditions

Things to consider when using antifungal medicines

Before you take antifungals there are a number of things you should discuss with your GP.

Allergies

You are generally advised not to take an antifungal medicine if you are allergic to the medicine or any of the ingredients used in it.

In some cases, such as when treating invasive fungal infections in hospital, your doctors may feel the benefit of the medicine outweighs the risk of an allergic reaction. They may decide to use the medicine and monitor you closely.

Other conditions

Be careful with some oral antifungals if you have problems with your heart, liver or kidneys.

Discuss your condition with your GP or pharmacist to find out which antifungal medicines are safe for you to use.

Topical antifungals

If you are using a topical antifungal medicine, such as a cream, avoid it coming into contact with:

• your eyes


• moist linings (mucous membranes), for example, inside your nose or mouth (unless it is a gel that is supposed to be used in your mouth)

Contraceptives

Some antifungal medicines are designed to be used on a man’s penis or in or around a woman’s vagina. Antifungal creams or vaginal suppositories (pessaries) are sometimes used to treat thrush.

However, these types of antifungal medicines can damage latex condoms and diaphragms, making them less effective. Use a different method of contraception while you are using the antifungal medicine, or avoid having sex.

Some types of antifungal medicines can also interact with oestrogens and progestogens, which are found in some types of hormonal contraceptives, such as the combined contraceptive pill. You may experience some breakthrough bleeding while taking your antifungal medicine, but your contraceptive protection should not be affected.

Only oral antifungal medicines interact with oestrogens.

Pregnancy

Many antifungal medicines are not suitable to take during pregnancy. Check the patient information leaflet that comes with your medicine to find out.

However, if you have vaginal thrush during pregnancy, your GP may prescribe an antifungal suppository that can be inserted into your vagina (a pessary) or an antifungal cream.

Breastfeeding

Small amounts of some medicines can pass into your breast milk and may then be passed on to your baby if you are breastfeeding. Check the patient information leaflet that comes with your antifungal medicine, as many medicines should not be taken while breastfeeding.

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Things to consider when using antifungal medicines

Categories: antifungal, antifungal medicine, antifungal medicines, Breastfeeding, information leaflet, medicine, medicines, patient information